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Black, Latino Americans more likely to be hospitalized for autoimmune hepatitis

Black and Latino Americans have a disproportionately higher hospitalization rate for autoimmune hepatitis than white Americans, and black people with autoimmune hepatitis had higher odds of in-hospital mortality, according to recently published data.

To characterize the burden of autoimmune hepatitis (AIH) and investigate ethnic disparities, Jason W. Wen, MD, from Augusta University, California, and colleagues accessed data on 1,933 hospitalizations with a primary discharge diagnosis of AIH from the National Inpatient Sample.

The researchers found that black patients were hospitalized for AIH at a 69% higher rate (95% CI, 1.58-1.81) and Latino patients at a 20% higher rate (95% CI, 1.12-1.28) compared with white patients. In contrast, Asian and Pacific Islander Americans were hospitalized at a 64% lower rate than white patients (95% CI, 0.29-0.43).

To evaluate this disparity, the researchers calculated all-cause hospitalization rates per 100,000 population for each race and found that black patients remained hospitalized at a higher rate (19%; 95% CI, 1.189-1.19) compared with white patients. Latino patients, however, had a 29% lower all-cause rate, and Asian and Pacific Islander Americans had a 50% lower rate compared with white patients.

After adjusting for age, sex, race, insurance status, community income and region, final analysis showed that patients hospitalized for AIH were more likely to be black (OR = 1.49; 95% CI, 1.28-1.75), Latino (OR = 1.83; 95% CI, 1.54-2.16), female (OR = 3.09; 95% CI, 2.69-3.56); older (OR = 1.01; 95% CI, 1.005-1.011); covered by non-Medicare or Medicaid insurance (P < .01); and in the second lowest quartile for median income by zip code (OR = 1.2; 95% CI, 1.04-1.38).

The researchers also found that black patients had an increased risk for mortality (OR = 2.81; 95% CI, 1.43-5.47) among patients hospitalized for AIH, after controlling for age, sex, insurance payer, residence, zip code income, hospital region and cirrhosis.

“Differences in the access and quality of care may delay diagnosis and result in inadequate or escalation of immunosuppressive therapy and suboptimal management of AIH in blacks and Latinos,” Wen and colleagues wrote. “Future studies should further elucidate the reasons behind these racial disparities in order to design targeted interventions, particularly as the number of people of color in the United States grows.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.